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General NPI Number Information
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NPI Number | 1104068535
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Entity Type | Organization
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Legal Business Name | SERENITY WELLNESS, LLC
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Dates
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Enumeration Date | 03/31/2009
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Last Update Date | 11/08/2011
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Provider Practice Location Address
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Address Line | 6785 W RUSSELL RD SUITE 140
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City | LAS VEGAS
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State | NV
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Zip | 89118-1861
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Country | US
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Telephone | 702-513-2815
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Fax | 877-293-1477
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Provider Business Mailing Address
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Address Line | 1909 N GREEN VALLEY PKWY SUITE B
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City | HENDERSON
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State | NV
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Zip | 89074-8352
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Country | US
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Telephone | 702-212-6357
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Fax | 877-293-1477
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHIE UEKIHARA
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Credential | D.C.
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Telephone | 702-212-6357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | B01249
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License Number State | NV
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